Abstract
In Europe and the United States, mortality due to breast cancer is decreasing. There are various reasons for this trend, including an increase in the rate of detection of early-stage breast cancers due to increased use of mammographic screening and the establishment of standardized systemic treatments from evidence-based medicine (EBM). On the other hand, in Japanese women, both breast cancer morbidity and mortality are increasing. Breast cancer mass screening has long been performed using clinical breast examination (CBE) alone. Mammographic screening for breast cancer was recommended in a notification issued by the Ministry of Health, Labour and Welfare in 2000. An important aspect of mammographic screening is quality control. The Central Committee for Quality Control of Mammographic Screening (Central Committee) was organized by six screening-related societies, and attempts have been made to establish a quality control system in Japan. The coverage rate of nationwide mammographic screening is presently very low,and is considered to be 31.4%. With such a low cover rate, it is absolutely impossible to reduce mortality due to breast cancer. This paper describes the current status and quality control system for mammographic screening in Japan and also the status of breast cancer screening in Europe and the United States. Furthermore, problems of breast cancer screening in Japan are highlighted, along with the need for practical measures such as implementation of quality control systems aimed at improving the cancer screening rate (with a target of 50%), funding support, and population-based screening (organized screening), based on the Cancer Control Act.
